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Case Reports
. 2022 Mar 17;2022(3):rjac080.
doi: 10.1093/jscr/rjac080. eCollection 2022 Mar.

Gastric metastasis from breast cancer presenting as dysphagia

Fotios S Fousekis  1 , Kostas Tepelenis  2 , Stefanos K Stefanou  3 , Christos K Stefanou  4 , George Pappas-Gogos  2 , Vasileios Theopistos  1 , Zoi Evangelou  5 , Davide Mauri  6 , Dimitrios K Christodoulou  1
Affiliations
Case Reports

Gastric metastasis from breast cancer presenting as dysphagia

Fotios S Fousekis et al. J Surg Case Rep. .

Abstract

Gastric metastasis from breast cancer occurs infrequently and causes non-specific symptoms, usually attributed to the underlying disease. Furthermore, endoscopic findings are almost identical to primary gastric cancer, making the immunohistochemical examination of biopsies necessary for diagnosis. We present the case of a 64-year-old woman who was diagnosed with lobular breast cancer 3 years ago and received chemotherapy with evidence of remission. The patient presented with dyspepsia and progressive dysphagia for the last 6 months, not responsive to PPI treatment. Upper endoscopy revealed partial occlusion of the cardio-esophageal junction and thickened gastric folds resembling linitis plastica. However, immunohistochemical analysis of endoscopic biopsies showed infiltration of gastric mucosa by lobular breast cancer cells, making the diagnosis of gastric metastasis. Therefore, clinicians' awareness of possible gastric metastasis is warranted in patients with a history of advanced breast cancer and severe gastric symptoms.

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Figures

Figure 1
Figure 1
The upper endoscopy shows the thickened gastric folds and the nodular and edematous mucosa.
Figure 2
Figure 2
Gastric metastasis of lobular breast carcinoma. Gastric biopsy of the corpus region reveals a carcinoma arranged loosely in a linear pattern throughout the stroma between the gastric glands (A, H/EX200). The neoplastic cells are small, uniform, round with minimal pleomorphism; the nucleus has evenly dispersed chromatin and no nucleoli (B, H/EX400). Immunohistochemically, the neoplastic cells are positive for keratin 7 (C, H/EX10) and negative for E-cadherin (D, H/EX10).
See this image and copyright information in PMC

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